title: Clinical challenges in drug induced pancreatitis: Presentation of two cases and review of the literature.
abstract: BACKGROUND
  A wide variety of drugs have been reported to cause pancreatitis. Although the incidence of drug induced acute pancreatitis is low, the disease is associated with substantial morbidity and mortality, which makes timely identification of the causative agent important.
  
  
  METHODS
  Herein, we report two patients with clinical, biochemical, and radiological evidence of acute pancreatitis. There were no etiologic factors except their prescribed drugs.
  
  
  CONCLUSIONS
  The majority of patients with acute pancreatitis recover uneventfully, but there remains an uncontrollable risk of mortality. It is prudent to withdraw a medication with a known association with acute pancreatitis. Necessity of multi-drug regimens especially in oncological patients however, presents a challenge.
  
  
  CONCLUSIONS
  Corticosteroid pulse therapy was easily detectable as the causative agent in our first case, but combined anti-neoplastic drug therapy and additional multi-drug regimen presented great difficulties in identifying single causative agent in our second patient.
authors.affiliation: Department of General Surgery, Trauma & Emergency Surgery Service, Istanbul University, Istanbul Medical Faculty, Turkey. Electronic address: yanar_fatih@yahoo.com.
authors.forename: Fatih
authors.initials: F
authors.lastname: Yanar
authors.forename: Orhan
authors.initials: O
authors.lastname: Agcaoglu
authors.forename: Inanc S
authors.initials: IS
authors.lastname: Sarici
authors.forename: Beyza
authors.initials: B
authors.lastname: Ozcinar
authors.forename: Ali F K
authors.initials: AF
authors.lastname: Gok
authors.forename: Kayıhan
authors.initials: K
authors.lastname: Gunay
authors.forename: Cemalettin
authors.initials: C
authors.lastname: Ertekin
keywords: Anti-neoplastic agents; Corticosteroid; Drug induced acute pancreatitis; Folinic acid; Transverse myelitis